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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 6, 762-769.
doi: 10.1302/0301-620X.87B6.14745  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Reducing the risk of dislocation after total hip arthroplasty

THE EFFECT OF ORIENTATION OF THE ACETABULAR COMPONENT

R. Biedermann, MD, Consultant Orthopaedic Surgeon1; A. Tonin, MD, Orthopaedic Registrar1; M. Krismer, MD, Professor, Chief Orthopaedic Surgeon1; F. Rachbauer, MD, Consultant Orthopaedic Surgeon1; G. Eibl, PhD, Scientific Assistant2; and B. Stöckl, MD, Consultant Orthopaedic Surgeon1

1 Clinical Department of Orthopaedic Surgery
2 Department of Biostatistics Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.

Correspondence should be sent to Dr R. Biedermann; e-mail: rainer.biedermann{at}uibk.ac.at

Malposition of the acetabular component is a risk factor for post-operative dislocation after total hip replacement (THR). We have investigated the influence of the orientation of the acetabular component on the probability of dislocation. Radiological anteversion and abduction of the component of 127 hips which dislocated post-operatively were measured by Einzel-Bild-Röentgen-Analysis and compared with those in a control group of 342 patients.

In the control group, the mean value of anteversion was 15° and of abduction 44°. Patients with anterior dislocation after primary THR showed significant differences in the mean angle of anteversion (17°), and abduction (48°) as did patients with posterior dislocation (anteversion 11°, abduction 42°). After revision patients with posterior dislocation showed significant differences in anteversion (12°) and abduction (40°).

Our results demonstrate the importance of accurate positioning of the acetabular component in order to reduce the frequency of subsequent dislocations. Radiological anteversion of 15° and abduction of 45° are the lowest at-risk values for dislocation.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General